Research in this project is currently focused on three areas. These are characterization of the survivors of the anthrax attacks of 2001; evaluation of the safety of smallpox vaccination in patients with HIV infection; and characterization of emerging respiratory infections including SARS and influenza. The anthrax study has enrolled a cohort of volunteers who are currently undergoing an extensive diagnostic evaluation. This area of research has been expanded to include non-human primate studies looking at the role of post-exposure vaccination as a means of preventing the development of inhalational anthrax following exposure to anthrax spores. Although little data support the notion that smallpox immunization is of serious risk to patients with well-controlled HIV infection, the vaccine is contraindicated in this population thus denying a significant segment of the population protection against this smallpox. To challenge this position a protocol is close to completion that will examine the effects of immunization in patients with HIV infection. To be ready to deal with emerging infectious diseases of the respiratory tract, a protocol has been developed to systematically study patients presenting with a compatible symptom complex. This protocol has been complemented by the development of treatment protocol that will utilize hyperimmune Ig to the SARS virus. In response to the threat of avian influenza, in collaboration with the World Health Organization efforts are underway to establish a clinical research network in SE Asia that will be able to conduct studies focused on the characterization and treatment of emerging influenza outbreaks.